Model of clinical decision-making ability and handover evaluation of emergency department nurses for inbound patients.

PURPOSE: Emergency department handovers are vital for patient safety. However, factors influencing nurses' clinical decision-making ability in inbound handovers remain insufficiently understood. We aimed to construct a hypothetical model of factors influencing clinical decision-making ability and handover evaluation among emergency department nurses for inbound patients in the emergency department. METHOD: Structural equation modelling was utilised to verify the goodness-of-fit of the model and the significance of the paths. Data were collected from 223 emergency department nurses using a structured web-based self-report survey conducted from 28 to 29 August 2023. Confirmatory factor analysis and structural equation modelling were performed. RESULTS: The final model showed an improved fit compared with the initial model. Clinical decision-making ability was directly influenced by knowledge-sharing behaviour, autonomy, and critical thinking disposition, and indirectly by work complexity, nursing work environment, knowledge-sharing behaviour, and autonomy. Handover evaluation was directly influenced by nursing work environment, knowledge-sharing behaviour, and clinical decision-making ability, with indirect effects from work complexity, nursing work environment, knowledge-sharing behaviour, and critical thinking disposition. CONCLUSION: We established a structural model that provides a foundation for educational programmes and interventions to enhance emergency department nurses' clinical decision-making and handover performance.